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Empowering Evidence 2014 Cost of Low Health Literacy in the U.S. A 2007 study from the University of Connecticut estimates the cost of low health literacy in the U.S. ranges from $106 billion to $238 billion annually This represents 7%-17% of all personal health care expenditures Source: Vernon et al. (2007) Low Health Literacy: Implications for National Health Policy

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Empowering Evidence 2014 IOM Findings People desire a patient experience that includes deep engagement in shared decision making –8 in 10 people want their provider to listen to them –8 in 10 people want to hear the full truth about their diagnosis –7 in 10 people want to understand the risks of treatments. Institute of Medicine (2012) Communicating with Patients on Health Care Evidence. goo.gl/v5XqGcgoo.gl/v5XqGc

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Empowering Evidence 2014 IOM Findings There is a gap between what people want and what they get regarding engagement in health care –8 in 10 people want their health care provider to listen to them, but just 6 in 10 say it actually happens. –Less than half of people say their provider asks about their goals and concerns for their health and health care. –9 in 10 people want their providers to work together as a team, but just 4 in 10 say it actually happens. Institute of Medicine (2012) Communicating with Patients on Health Care Evidence. goo.gl/v5XqGcgoo.gl/v5XqGc

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Empowering Evidence 2014 IOM Findings People who are more engaged in health care report a better experience –Patients whose providers listen to them, elicit goals and concerns, and explain all the options, among other things, are 3 to 5 times more satisfied with their providers Institute of Medicine (2012) Communicating with Patients on Health Care Evidence. goo.gl/v5XqGcgoo.gl/v5XqGc

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Empowering Evidence 2014 IOM Findings People have clear preferences for evidence communication. –Medical evidence, the clinician’s expertise, and the patient’s goals and concerns are all critical to making medical decisions. –To describe medical evidence, people prefer the phrases “what is proven to work best” and “the most up-to-date medical evidence, including information about the risks and benefits.” Institute of Medicine (2012) Communicating with Patients on Health Care Evidence. goo.gl/v5XqGcgoo.gl/v5XqGc

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Empowering Evidence 2014 How Can I Help My Patients Understand? Slow down Use plain, nonmedical language Show or draw pictures Limit the amount of information provided and repeat it Use the “teach-back” technique Create a shame-free environment by encouraging questions Source: AMA (2007). Health literacy and patient safety: Help patients understand

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Empowering Evidence 2014 Improve Comprehension of Numerical Information Provide numeric likelihoods of risks and benefits Provide absolute risks, not just relative risks Keep denominators constant for comparisons Use visual aids when possible Reduce the amount of information shown as much as possible Provide both positive and negative frames Make the differences between baseline and treatment risks and benefits clear. Apter et al. (2008) Numeracy and Communication with Patients: They Are Counting on Us. J Gen Intern Med.